Increasing Access to Care for Transgender/Gender Diverse Youth Using Telehealth: A Quality Improvement Project

Russell, Meredith R; Rogers, Rebecca; Rosenthal, Stephen M.; Lee, Janet Y.

doi:10.1089/tmj.2021.0268

Cited by 13 publications

(10 citation statements)

References 43 publications

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“…Our results support those of past surveys and quantitative research, which have shown that youth prefer in-person visits to telemedicine [ 8 - 11 ]; however, our qualitative discussions regarding benefits and drawbacks of each modality further indicate that the choice is not so simple. Although a plurality of TGD youth in our study indicated a preference for in-person visits, they also recognized the value of telemedicine to themselves and others for less complex or follow-up visits and the impact it may have in facilitating access to care [ 12 ]. Given variations in needs and visit complexity, our results suggest that both in-person and telemedicine modalities should be options for the provision of gender-affirming care, and that patient needs and constraints should be considered as these services become more widely implemented.…”

Section: Discussionmentioning

confidence: 99%

“…More recent research during the pandemic with a nationally representative sample of youth has shown that young people see value in telemedicine for minor concerns or follow-up care, but that most still prefer in-person visits [ 10 ]. Similarly, research conducted before the pandemic showed that just under half (47%) of TGD youth were interested in telemedicine, but they, too, preferred to use this modality for follow-up care [ 9 , 11 , 12 ]. However, telemedicine interest was especially high among TGD youth who had less parental support for their identities [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Understanding Transgender and Gender-Diverse Youth’s Experiences Receiving Care via Telemedicine: Qualitative Interview Study

Kahn

Anan

Bocek

et al. 2023

JMIR Pediatr Parent

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Background Access to virtual care has increased since the beginning of the COVID-19 pandemic, yet little is known about transgender and gender-diverse (TGD) youth’s experiences and perspectives on receiving care via telemedicine. Objective The purpose of this study was to explore these experiences to (1) inform necessary changes to the provision of pediatric gender-affirming care and (2) help providers and health systems determine if and how telemedicine should be made available post pandemic. Methods Youth (aged 14-17 years) who completed a telemedicine visit in the Seattle Children’s Gender Clinic were invited to participate in a semistructured interview exploring perceived advantages or disadvantages of telemedicine and preferred visit modalities. Interview transcriptions were analyzed by 2 research team members using an inductive thematic analysis framework. Results A total of 15 TGD youth completed an interview. Commonly cited advantages of telemedicine were convenience and comfort with having visits in their own environments. Reported disadvantages included technical issues, discomfort with the impersonal nature, lack of familiarity with the platform, and privacy concerns. Overall, slightly more youth preferred in-person visits over telemedicine, referencing both specific characteristics of the clinical visit (ie, initial vs return and complexity) and proximity to the clinic as reasons for this preference. Although a plurality of TGD youth preferred in-person visits, they also recognized the value of telemedicine and the impact it may have in facilitating access to care. Conclusions Given the variations in needs and visit complexity, our study supports the provision of both in-person and telemedicine modalities as options for pediatric gender-affirming care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding Transgender and Gender-Diverse Youth’s Experiences Receiving Care via Telemedicine: Qualitative Interview Study

Kahn

Anan

Bocek

et al. 2023

JMIR Pediatr Parent

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“…Similarly, in this study, gender-related care represented 65% (46/71) of care visits, suggesting that telemedicine is crucial for accessing gender-related care after the pandemic. Prior studies of gender-diverse youth have shown that youth have an interest in receiving care through telehealth [ 6 ], and studies of young adult patients and caregivers of youth accessing gender transition–related services have shown preliminary data indicating that telehealth visits are more acceptable and convenient than in-person visits [ 13 ]. For all adolescent health–related visits, our results similarly indicate that for many caregivers of adolescent patients, telemedicine is at least equally as acceptable and satisfactory as in-person medical visits.…”

Section: Discussionmentioning

confidence: 99%

“…Studies related to privacy and telehealth for adolescents have shown mixed results. A survey study conducted at a pediatric center that provides gender-affirming care found no differences in caregiver perceptions of privacy between in-person visits and video visits [ 13 ]. However, an adolescent medicine clinic that cares for patients with disordered eating and reproductive health concerns found that 22% of youths believed that the privacy of telehealth visits was inferior to that of in-person visits, whereas only 2.5% of caregivers shared that belief [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Acceptability of Telemedicine Among Parents of Adolescent Patients in an Adolescent Clinic: Cross-sectional Survey Study

Olateju

Cervantes

Dowshen

et al. 2022

JMIR Pediatr Parent

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Background Since the beginning of the COVID-19 pandemic, new literature has described the perceptions of adolescent patients on the use of telemedicine for their health care, but less attention has been devoted to parents’ and caregivers’ perspectives on telemedicine usage for their adolescents. Parents’ perspectives are important, as they undoubtedly influence how children learn to make decisions about their health care. Objective This study describes the level of acceptability (measured based on accessibility and satisfaction) expressed by caregivers of adolescent patients with regard to telemedicine visits in an urban adolescent medicine practice. Methods A cross-sectional survey was sent electronically to parents and guardians of patients aged <18 years who completed outpatient telemedicine visits to an adolescent medicine practice in Chicago, Illinois, from March 2020 to February 2021. The questions focused on accessibility and satisfaction. The data were analyzed to describe response frequencies. Results Among a sample of 71 survey respondents, the vast majority reported that telemedicine was very easy to use (58/71, 82%) and was at least as convenient as in-person visits (70/71, 99%). Over 90% of respondents reported that their adolescents’ needs were addressed (69/69, 100%) and that they were at least as comfortable with the level of privacy and the confidential conversations between their adolescents and medical providers in telemedicine visits (65/71, 92%) as they were with those in in-person visits. Conclusions Our findings suggest that parents and guardians find telemedicine to be an acceptable way for their children and adolescents to receive appropriate health care.

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“…The majority of TGD patients express satisfaction with telemedicine services as evidenced by improved uptake in care that is provided remotely [ 68 ]. A study of gender diverse youth indicated that patients were significantly more likely to prefer a video visit instead of an in-person office visit [ 69 ]. A separate study in people of transgender experience between 12 and 26 years showed as many as 50% expressed interest in receiving gender care via telemedicine, including a majority preferring to receive primary medical care that way [ 70 ].…”

Section: Telemedicinementioning

confidence: 99%

Transgender Individuals and Digital Health

et al. 2022

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Purpose of review The goal of this review is to assess the use of digital technologies to promote the health and well-being of transgender and gender diverse (TGD) people. Recent findings TGD individuals experience numerous health disparities, including low uptake of HIV prevention strategies, such as pre-exposure prophylaxis, increased HIV incidence, and suboptimal HIV-related outcomes. These health disparities are the result of widespread intersectional stigma on the basis of gender identity, gender expression, socioeconomic class, race, and ethnicity, which negatively impact access to general medical and transgender-specific health care. TGD individuals often delay or avoid essential medical services due to fear of discrimination. Clinicians frequently lack training, competence, and skills in transgender medicine, further exacerbating the health disparities faced by TGD people. Digital technologies have been used to improve research and clinical care for TGD populations through various modalities; telemedicine, telehealth and mHealth. Summary Digital health technologies, including HIT-enabled clinical decision support, telehealth, telemedicine, and mHealth, offer innovative ways to improve health care access, improve quality of care, and reduce health disparities for TGD populations, including and beyond HIV outcomes, through enhanced care delivery, clinician education, and enhancing social support networks.

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Increasing Access to Care for Transgender/Gender Diverse Youth Using Telehealth: A Quality Improvement Project

Cited by 13 publications

References 43 publications

Understanding Transgender and Gender-Diverse Youth’s Experiences Receiving Care via Telemedicine: Qualitative Interview Study

Understanding Transgender and Gender-Diverse Youth’s Experiences Receiving Care via Telemedicine: Qualitative Interview Study

Acceptability of Telemedicine Among Parents of Adolescent Patients in an Adolescent Clinic: Cross-sectional Survey Study

Transgender Individuals and Digital Health

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